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Research > Improving the Evidence Base for CKD
Datasets > Improving the Evidence Base for CKD

Improving Evidence-Based Primary Care for Chronic Kidney Disease

This is a randomized controlled trial of point-of-care computer decision support (CDS) plus full TRANSLATE model of practice change, versus CDS alone. The study aims to analyze differences in promoting evidence-based care in primary care practices. Thirty-six practices will be recruited for this study. Patient inclusion criteria: adult patients with estimated Glomerular Filtration Rate (eGFR) of < 60 and > 15ml/min/1.73m2 confirmed with repeat testing over three or more months.

A process evaluation will be conducted between the CDS practices with facilitation and the CDS only practices to assess clinical outcomes of CKD progression and all-cause mortality. Because all data will be gathered from the practice EHRs, availability of data will not be dependent on participation in interventions, allowing robust estimates of effectiveness of interventions among those for whom they are intended as well as sub-analyses among those who participate. A true contemporary control for secular trends will be a third arm of the study. This will be practices with the same characteristics as the intervention practices will be looked at for the same time period, but they will not have had either computer decision support or practice facilitation.

More Information

Video for practice recruitment (YouTube) 

Academic Detailing slides (PowerPoint)

One-page guide for treatment of CKD (PDF)

TRANSLATE Model slides (PowerPoint)

TRANSLATE rubric for evaluation (Excel file)

Publications

Effect of 2 Clinical Decision Support Strategies on Chronic Kidney Disease Outcomes in Primary Care: A Cluster Randomized Trial
Carroll JK, Pulver G, Dickinson LM, Pace WD, Vassalotti JA, Kimminau KS, Manning BK, Staton EW, Fox CH. (2018)
JAMA Netw Open. 2018 Oct 5;1(6):e183377. doi: 10.1001/jamanetworkopen.2018.3377
Abstract | Full Text

Extracting Deep Phenotypes for Chronic Kidney Disease using Electronic Health Records
Luong, Duc Thanh Anh; Tran, Dinh; Pace, Wilson D.; Dickinson, Miriam; Vassalotti, Joseph; Carroll, Jennifer; Withiam-Leitch, Matthew; Yang, Min; Satchidanand, Nikhil; Staton, Elizabeth; Kahn, Linda S.; Chandola, Varun; and Fox, Chester H. eGEMs (Generating Evidence & Methods to improve patient outcomes) 2017: Vol. 5: Iss. 1, Article 9.
Abstract and Full Text

Improving evidence-based primary care for chronic kidney disease: Study protocol for a cluster randomized control trial for translating evidence into practice (TRANSLATE CKD)
Fox, H. Chester; Vest, M. Bonnie; Kahn, Linda; Dickinson, L. Miriam; Fang, Hai; Pace, Wilson; Kimminau, Kim; Vassalotti, Joseph; Loskutova, Natalia, Peterson, Kevin
Implementation Science. 2013; 8(88). DOI: 10.1186/1748-5908-8-88
Abstract | Full Text

Dataset Description

Study Name Description Type of Patients Included N Data Elements
Translate CKD This group randomized controlled trial will test the extent to which CDS plus practice facilitation promotes evidence-based care and improves the clinical outcomes of reduced disease progression and mortality in primary care practices. Adults over age 18 with the diagnosis of CKD and/or one eGFR <60 within last 48 months 22683
  • ALT
  • Gender
  • Race/Ethnicity
  • Current smoking
  • Height and Weight/BMI
  • Total visits/encounters
  • Hemoglobin
  • HDL
  • LDL-C
  • Triglycerides
  • Year of Birth
  • AST
  • Nephrologists referrals
  • HbA1c
  • 25 OH Vitamin D
  • Serum Phosphorous
  • PTH intact
  • All medications
  • All diagnosis – Active & Inactive
  • Blood pressure
  • Estimated GFR
  • Urine albumin/creatinine ratio
  • Medicare Insurance Coverage
  • Creatinine